DMARD tapering/withdrawal studies
| Author | Acronym | Type | Arms* | N† | ERA/RA | DMARDs | MODE | IC | Type | SUS | REM‡ | FO |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Tanaka et al24 | HONOR | UC | 2 | 75 | RA | ADA | STOP | REM | DAS28 <2.6 | >6 m | 48% | 1 |
| Saleem et al25 | – | UC | 1 | 47 | ERA/RA | TNFi | STOP | REM | DAS28 <2.6 | >6 m | 15%–59% | 2 |
| Brocq et al26 | – | UC | 1 | 21 | RA | TNFi | STOP | REM | DAS28 <2.6 | >6 m | 25% | 1 |
| Aguilar-Lonzano et al28 | – | UC | 1 | 45 | RA | TOC | STOP | REM | DAS28 <2.6 | – | 44% | 1 |
| Naredo et al50 | – | UC | 1 | 77 | RA | TNFi | TAP | REM | DAS28 <2.6 | >6 m | 55% | 1 |
| Iwamoto et al51 | – | UC | 1 | 40 | RA | TNFi, TOC | STOP | REM | DAS28 <2.6 | – | 60% | 0.5 |
| Alivernini et al52 | – | UC | 1 | 42 | RA | TNFi | TAP/STOP | REM | DAS44 <1.6 | >6 m | 61% | 0.5 |
| Tanaka et al23 | RRR | UC | 1 | 102 | RA | IFX | STOP | LDA | DAS28 ≤3.2 | >6 m | 55% | 1 |
| van der Maas et al27 | – | UC | 1 | 51 | RA | IFX | TAP | LDA | DAS28 ≤3.2 | >6 m | 16%–45% | 1 |
| Nishimoto et al29 | DREAM | UC | 1 | 187 | RA | TOC | STOP | LDA | DAS28 ≤3.2 | – | 13% | 1 |
| van Herwaarden et al30 | – | UC | 1 | 22 | RA | TOC | TAP | LDA | DAS28 ≤3.2 | – | 55% | 0.5 |
| Quinn et al31 | 20TNF | SA | 2 | 20 | ERA | IFX | STOP | REM | –§ | – | 70% | 1 |
| Klarenbeek et al34 | BEST | SA | 1 | 243 | ERA | SD/IFX | TAP | REM | DAS44 <1.6 | >6 m | 23% | 2 |
| Nam et al38 | IDEA | SA | 1 | 14 | ERA | ETA | STOP | REM | DAS44 <1.6 | >6 m | 42% | 0.5 |
| Nam et al39 | EMPIRE | SA | 1 | 9 | EA/ERA | IFX | STOP | REM | TJC0/SJC0 | – | 25% | 1 |
| Huinzinga et al41 | ACT-RAY | SA | 1 | 238 | RA | TOC | STOP | REM | DAS28 <2.6 | – | 14% | 1 |
| Detert et al36 | HIT-HARD | SA | 1 | 155 | ERA | ADA | STOP | –¶ | –¶ | – | 89% | 1 |
| Smolen et al35 | OPTIMA | SA | 2 | 207 | ERA | ADA | STOP | LDA | DAS28 ≤3.2** | – | 66%–81% | 1 |
| Soubrier et al37 | GUÉPARD | SA | 1 | 69 | ERA | ADA | STOP | LDA | DAS28 ≤3.2 | – | 33% | <1 |
| Emery et al40 | AVERT | SA | 1 | 222 | ERA | ABA | STOP | LDA | DAS28 ≤3.2** | – | 15% | 1 |
| ten Wolde et al21 | – | RCT | 2 | 285 | RA | SD | STOP | REM | ACR | >6 m | 62% | 1 |
| Ahern et al22 | – | RCT | 2 | 38 | RA | SD | TAP | REM | TJC0/SJC0 | >6 m | 21% | 0.5 |
| Haschka et al15 | RETRO | RCT | 3 | 101 | RA | All†† | TAP/STOP | REM | DAS28 <2.6 | >6 m | 48%–61% | 1 |
| Emery et al42 | PRIZE | RCT | 3 | 193 | ERA | MTX/ETA | STOP | REM | DAS28 <2.6 | – | 24%–63% | 0.5 |
| Fautrel et al43 | STRASS | RCT | 1 | 137 | RA | TNFi | TAP | REM | DAS28 <2.6 | >6 m | 74% | 1.5 |
| Smolen et al44 | PRESERVE | RCT | 3 | 604 | RA | ETA | TAP/STOP | LDA | DAS28 ≤3.2 | >6 m | 43%–79% | 1 |
| van Vollenhoven et al45 | DOSERA | RCT | 3 | 91 | RA | ETA | TAP/STOP | LDA | DAS28 ≤3.2 | >6 m | 52% | 1 |
| van Herwaarden et al46 | DRESS | RCT | 2 | 180 | RA | ADA, ETA | TAP | LDA | DAS28 ≤3.2 | – | 88% | 1.5 |
*Number of treatment arms during the tapering phase.
†Number of patients subjected to tapering.
‡% of patients with successful tapering. §Not defined but most in DAS2.6 remission.
¶No specific definition.
**DAS28 based on C-reactive protein.
††All conventional DMARDs as well as TNFi and TOC.
ABA, abatacept; ACR, American Colleague of Rheumatology; ADA, adalimumab; ARA, American Rheumatism Association criteria from 1981; DAS28, disease activity score 28 (based on erythrocyte sedimentation rate if not stated otherwise); DMARDs, disease-modifying antirheumatic drugs; EA, early arthritis; ERA, early rheumatoid arthritis; ETA, etanercept; FO, follow-up time after tapering/stopping in years; (–) means not defined or less than 6 months; IC, inclusion criterion; IFX, infliximab; LDA, low disease activity; RA, established rheumatoid arthritis; MTX, methotrexate; RCT, randomised controlled trial; REM, remission; SA, subanalysis of randomised controlled trial; SD, synthetic DMARDs; SJC, swollen joint count; STOP, withdrawal of DMARD; SUS, sustained remission of at least 6 months (6 m) before tapering/stopping of DMARDs; TAP, dose tapering of DMARD; TJC, tender joint count; TOC, tocilizumab; TNFi, tumour necrosis factor inhibitor; UC, uncontrolled study.